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Well just me .. forget the hypnosis stuff, take the time to study the test subject material instead, reviewing notes the night after the lecture is a good way to put info into long term memory, pass on any medications and keep caffeine to a minimum, agreed with LS don't cram, proven not to be effective and take the night off before any majors, hey dress up take time to look good and therefore feel good about yourself = confident. A friend writing the Final Exams for Respiratory did that ... hey he walked in in a 3 piece suit NOT my cup of tea but catch the positive energy is all. A positive attitude is TWTG ... I try to avoid classmates that you know are very up tight themselves and I always sit at the very front seat with some decent view of the outside world ... because its ONLY a test ..the real test comes when its for real. Oh and RTFQ ... (Read the ****** Question) don't read into it, if its a multiple guess or K type eliminate right off the bat what you know is incorrect,as LS states hey I do not listen to the examiners I write all over the damn Exam Paper ..I paid my money to take the test ... they can print off another for the next Student. cheers

Good Grief, my worse nightmare come true .... a helo is just another mode of transport, and yes the stats are shocking as of late .... best let that student review the FAA releases on the investigations. But are you saying : “She’s fat, smells bad, and looks like Stalin” too ? NickD : yes agreed skepticism does come with age and experience but then again so does situational irony .... I have sent your "homework project" to many worldwide offshore medics and the general concesis is that a change of clothing required after "EMS peer review" I certainly hope the Producers of this show get the link, AND hopefully they are now "lurkers" on EMT city, one can only hope. cheers

So you used to put the drunks behind the wheel now your going to save them ? hmmm ok this is plausible, sure hope you have put away some tips I hope to get through school ...just saying its a bloody shame that you guys are not paid decently and that the volunteer service are undercutting you ... honestly after 4 years on this site I can see THAT light. Firstly if you have actually spent > 25 years doing this job I believe your personal sensitivities would be a bit more affected, we are not "mad" we are using the pen as it can be more effective than the sword, this is a TV show that disrespects the profession and yet unfortunately many viewers are keyed into the just the blood, guts, glory and explosions and will believe it is closer to a documentary and again geared to the grade 8 education that most TV shows are focused ie SEX + Fast cars + Explosions = Success in TV ..meh ... I watch Discovery and documentaries and TLC, or the military channel the demographics are a changing in the viewing public. Fact of the matter is the real call volume is NOT TRAUMA at all it is complex metabolic problems, cardiac and seizures that are the top of the hit parade (not sexy in the slightest btw)the vast majority of calls, ETOH being the underlying social problem, I wonder if that "theme" will surface hey and lets not forget my favorite type call ... retuning the grannies back home AFTER they have recovered ... nothing better in my books. Many times EMS is like urinating in a dark pair of pants ... You do get that warm all over feeling, but YOU hope no one notices. This show needs better writers, that listen to advisors and a real big name to become truly successful TV series (we can only hope) I like Will Smith .. ever see "Seven Pounds" just saying RABBIT is headed to the stew pot if he shows his face around any true professionals in EMS, I love how they kill off and very unexpectedly the CSI "special agents" just to keep it real, cause that is real life for cops and if the producers are watching maybe they will take a hint Secondly your NOT going to watch the show BUT your NOT boycotting ?? I am a bit confused Now a reality check will a "boycott work ?" .. NO is the short answer. Bledsoe stepping up to the plate and just suggesting that, well it WILL send a message count on it! Rock ON BEB !

AS IF YOU have a membership to a yacht club and have the deck shoes that match your captains hat ? ROLFLMAO.

Oh crap I though someone said Piece ? Obama may be watching too much Letterman ...I dunno ...

Hey anyone can PM me ... they just have to be a member of EMT city and hey Admin would like that to increase our membership Only one problem ... I WAS thrown out of Texas after EMStock and Dust as the evidence

Ah come on people, its a condolence prize for loosing his bid for the next summer Olympics ... Now also in the news, Obama approved NASA shooting a missle and trying to start a war with all the green people on the MOON! Seriously quite the feedback in the media and this is super controversial, this Obama dood has actually flipped this calling it a Call to enhance his position for Worldwide Peace and he has accomplished more in 9 months than most administrations laying the groundwork (thats what many very knowledgeable types are saying).... just saying his speech in the UN to remove "nukes" was stellar and hey for comparison ... Look to the many others politicians that received this award, some of the previous comments are a tad jaded based on emotion .... as Squint looks for level 3 Body Armour. I think John Lennon should have received the Nobel Prize ... but thats just IMHO. cheers

Dear Mike: Speak for yourself there Mike, thanks could it be that the PC comments may be aimed at assuring continued revenue from standbys coverage ... just think how much the producers could save ca$h wise if they actually HAD a REAL REMT-P playing a subordinate role ... just thinking out loud here. once again I am available and it IS snowing here I can be contacted at Idontwannafreezemyassoff@leaveAB.ca.

The Hare and the Sager were good in there day and as Dust I can't count how many I have put on ... hey just too bad Hitler didn't get to use the REEL splint (ps also free gak from Roger)

Cherniack, Shapirio, Kasmerick (sp) and Oakes ... look in NAIT or SAIT required book list.

Zactly ... I never bash free gak.

Nice power point but I think oscillation is a tad out of the league of most viewers, that said no harm, but are not the deaths we are observing due to underlying medical conditions and secondary bacterial infections (not that ARDS is NOt a serious consideration) and pregnancy ..i believe last count in the US was 28 fatalities in pregnant patients ?

Agreed .... donate nares ... nah mandatory nasal catheter, I will buy. Ok I know your making jest BUT it depends on what books you read, there is a plethora of respiratory text books out there dont restrict yourself to the dummied down EMS books ... well accept for Bledsoe's books that is.

I use the open door technique ... why do all that work when its - 40 C ... and nothing survives in that Seriously no matter how well you wipe surfaces down it is quite dependent on the type of anti infecting agent used, cheapest and most cost effective agent is Bleach because it can kill TB a very resilient spore producing bad bug ... and in passing generally speaking if I started doing swabs and cultures on any gut wagon one would be astounded at what can be grown in a petri dish. I laugh out loud when I see the label claiming that the "cleaner" kills the Aids virus ... and it doesn't survive out of the human body for more than 90 seconds. cheers and happy deep cleaning

Vent ... this does bring up an interesting point maybe we should be asking if inhaled steroids decrease hospitalization/ admissions for H1N1 patients. The big question for me remains WHO kissed the Pig in the first place ?

Interesting all these Oxygen queries as of late ... as Ventmedic mentioned there are devices like the Optimizer type N/C that can be set at much higher levels than some "protocol" these include concepts like the Venturi effect (flared tips) and some have diaphragms that upon inspiration allow an increased reservoir flow upon inspiration, of this I know well because I had the extreme pleasure of wearing one for 2 weeks ... that said. Generally speaking the reservoir in the standard anatomy the naso and oro pharynx is flooded with flows equal to 6 lpm (some books say about .40 for FiO2)higher flows over 4 are generally quite uncomfortable, although longer term the "over the ear" tubes are far more uncomfortable and can lead to skin breakdown (just in passing personal commentary) Now using common sense if a patient does not tolerate a mask ... and many patients feel they are being suffocated, besides they smell like chemicals ... so if a patient does not tolerate a mask and they require and tolerate 8 liters per minute well who's going to quote "some book" if it works. Use a pragmatic approach in respiratory care is my humble opinion. cheers

Yup funny how that works, so many Asthmatics forget or can't afford to have a spare MDI on hand, a hospital visit is far more costly, and the patients are typically far worse, and besides those MDIs are single patient use and I keep losing them in a patients pocket whats this script for dispense thing ...must be american .. I know it reduces re:admissions to ER too. cheers Kristjansson S, Berg-Kelly K, Winso E. Inhalation of racemic epi in treatment of mild to moderately severe croup. Acta Paediatri 1994;83:1156-1160 This is a study based on Racemic vs Placebo, I know off topic but I am of the opinion that inhaled steroids are far more beneficial, and Ventolin with ipatromium bromide are with far fewer side effects and longer acting. cheers

Good and report back ... besides what else is there to do in Merrit anyway ? May be but very dependent on the fitting of the mask I would suspect. The spacers could be sterilized and/or could follow the patient to wards (cost efficacy)if admitted and some types can even be used in-line on a circuit, ah now your making ME think rock shoes. I will do some emailing to some other RT supplier friends and see what we can come up with no point in reinventing the wheel. There is a study (somewhat related) with Paeds and racemic EPI over Ventolin (SVN) for moderate to severe croup and was called disappointing. Levalbuterol vs ventolin with no clear advantage in acute exacerbations of childhood asthma although hospitalizations were marginally lower ... I have the briefs of the studies if you so desire, to use as a sedating bed time story. What is surprising that PALS has jumped on this EPI bandwagon for all croup ... and I am so not a fan of putting BPs and heart rate into the troposphere. cheers

I have no idea how that happened ? Back to the regular scheduled programming.

Ok thats a good one too BEB ... I think the spelling error was intentional but thats just from a "swamp donkey's" perspective. Oh any links to get more CRAP for my belt .... good one NickD. cheers

Whoo Hoo thanks Lord chbare, back at you and one for medicv83 for just starting the thread, good learning post from all, and its hard to keep up with the other oxygen pple. As for 4c6 .... I think a negative rep just to piss him off wtf is the "dog in a car" theory ? Do you talk to dogs or watch to many episodes of the Dog Whisperer ? .... cheers ps the rule of thumb(s) or now referred too as the 4cmk6 Protocol/ Guidelines aint a bad way to go using a Pulse Ox, but I sense a repremand with the A/a gradient vent introduced ... oh well live and learn.

Ah back on thread right then .. well if there is any sign or symptom of bronchospasm then why not treat with a beta 2 selective drug ie risk vs benifit... maybe use flow volume loops on that graphics package on the PB 840 to document on ventilated patients (outside voice there) and on the spontaneously breathing H1N1 patient use bedside spirometry or even a cheap "quicky" study with Peak flow meters to validate further study .... hey I bet Galaxo would be non board with Spacers and MDI's too. Food for thought. But IV ventolin ... umm last patient I gave 250 mics to back in the day got really pasty and dropped his B/P, it was transient BUT the patient did stop wheezing but thats anicdotal as when we used 90% ETOH SVN on Flash PE ... cheers

Ah shucks ....

Ah the fledgling RRT ... Oxygen absorption micro atelectasis, EXPLAINED, nicely done. Funny we (EMSers) throw everyone on O2 then only to start weaning them off as soon as we introduce ourselves as RTs or as Vent medic states "titrate", got to love it and with newer studies in regard to treatment of CHF maybe down the road this will become a household EMS concept ...one can only hope.... Oxygenation can be far more complex than just looking at a pulse ox and with the now introduction of A/a Gradients ... hey don't hurt anyone Vent ... Oh in passing wtf in the reputation department ... I only warrent a 2 ...sniff

She did NOT I was tricked into transferring genetic material, thats my story and I am "sticking" to it. Umm ever hear the term: BITE ME ?